Main navigation

Breadcrumb

Preventing mother to baby transmission

Without the right treatment and care, a woman living with HIV can pass HIV on to her baby. This is called mother-to-child transmission (MTCT) or vertical transmission. Taking anti-HIV drugs can dramatically reduce the risk of you passing on HIV to your baby.

Content

How can vertical transmission be prevented?

Text

There is a set of effective strategies that prevent mother-to-child transmission from taking place. These are called PMTCT: prevention of mother-to-child transmission.

Many women living with HIV have given birth to HIV negative children by taking these precautions:

Having a vaginal delivery (rather than a caesarean delivery) if your HIV viral load is detectable.

Breastfeeding.

How does HIV treatment prevent mother-to-baby transmission of HIV?

Text

Everyone with HIV is now recommended to start treatment at diagnosis whatever their CD4 count.

There are two different ways in which anti-HIV drugs act to prevent MTCT:

They reduce your viral load so your baby is exposed to less HIV while in the womb and during birth. The aim of HIV treatment is to get, and keep, your viral load to undetectable levels. (If your viral load is below 50, it’s called undetectable although most clinics in the UK can measure below 20 copies/ml.)

Some anti-HIV drugs cross the placenta and enter your baby’s body, preventing the virus from ever taking hold. Newborn babies are given a short course of anti-HIV drugs after they’re born when their mother is known to be HIV positive.

You can reduce the risk of HIV transmission further by having a managed delivery. Your doctor will look at your viral load when you are 36 weeks pregnant and discuss options with you.

Antenatal care for women living with HIV

Text

You're likely to be looked after by a team of healthcare workers during your pregnancy.

You’ll still get your care at your HIV clinic. But, as well as your HIV doctor and clinic staff, you’re likely to see an obstetrician (a doctor who delivers babies), a specialist midwife and a paediatrician.

Other people you may see, depending on the kind of help you’ll need, could include:

a peer support worker

a community midwife

a counsellor

a psychologist

a social worker or a patient advocate.

They’ll help you with issues like problems with housing, finances or alcohol and drug use. They can provide support and advice on your eligibility for free NHS treatment and other financial help, such as help with formula feeding.

Like all health professionals, the members of your antenatal care team are bound by confidentiality guidelines and will not disclose your status to anyone without your consent.

How should I feed my baby?

You may have mixed feelings about bottle-feeding (especially if most other mothers you know breastfeed), but remember that over 8 out of 10 mothers in the UK are feeding their babies with formula milk by the time the baby is 3 months old.

Holding your baby in a breastfeeding position with lots of eye contact and skin-to-skin contact will create the same close bond.

If you are not breastfeeding, people will not think it is unusual, or think it has anything to do with being HIV positive.

Family and friends may ask why you aren’t breastfeeding, and dealing with their questions can be difficult. If you don’t want to talk about HIV, you could say that you are not producing enough milk, that you have mastitis (inflammation of the breast), or that you have cracked nipples.

If you choose to breastfeed:

If you are on treatment with an undetectable viral load and choose to breastfeed your baby, then see your doctor before you start. Your clinic team can help you make it as safe as possible for your baby, but it will not be as safe as using formula.

You should breastfeed your baby for as short a time as possible, and the baby should only have breastmilk for the first 6 months, and not formula or cow’s milk too.